Photo Credit: SeventyFour
At Maui Derm, held January 22-26, 2024 in Maui, Linda Stein-Gold, MD, presented as part of “Challenging Cases in Psoriasis.”
For a study not directly included in this presentation but related to the topic, Dr. Stein-Gold and colleagues conducted a survey to “understand how disease perceptions, including disease severity, treatment goals, and quality of life (QOL), have evolved recently, especially for mild-to-moderate psoriatic disease.”
The Nuanced Landscape of Psoriasis
The study delved into the nuanced landscape of psoriasis (PsO) in the US, shedding light on the intricate interplay between patient experiences and physician perspectives. Despite the advent of new treatments, PsO continues to pose substantial challenges to patients and healthcare professionals alike, with a profound impact on health-related QOL. This investigation, conducted as part of the Understanding Psoriatic Disease Leveraging Insights for Treatment (UPLIFT) survey, aimed to unravel the evolving perceptions and experiences surrounding these conditions among both patients and physicians.
The UPLIFT survey reveals that patients still grapple with a high disease burden, particularly when facing bothersome symptoms like itch, musculoskeletal issues, or PsO in sensitive areas such as the face and scalp.
The treatment landscape has witnessed significant expansion with the approval of various biologic and non-biologic therapies by the FDA between 2012 and 2020. However, barriers to access persist, including eligibility criteria, patient preferences, and physician prescribing practices. The UPLIFT survey aimed to delve deeper into these issues to glean insights into disease impact on QoL and treatment perceptions.
A Holistic View of Challenges Faced in Psoriasis Management
Methodologically, the UPLIFT survey adopted a comprehensive approach, incorporating input from an academic steering committee comprising international experts in rheumatology and dermatology, alongside feedback from patients, physicians, and advocacy groups. Conducted between March and June 2020, the survey encompassed a wide array of assessments, including respondent demographics, clinical characteristics, disease burden, current and historical treatments, treatment goals, and recommendations. Both patient and physician perspectives were meticulously captured, providing a holistic view of the challenges faced in managing PsO.
Key findings from the UPLIFT survey underscored several critical points:
- Prevalence and Demographics: Among US respondents, PsO affected a significant portion of the population. The mean age of patients was 46.3, with a slight female predominance.
- Disease Characteristics: Patients reported varying degrees of disease severity, with a substantial percentage experiencing moderate to severe symptoms. Additionally, PsO in special areas, such as the scalp, was prevalent and associated with heightened disease burden.
- Treatment Patterns: Treatment modalities varied, with a notable portion of patients not currently using prescription therapies. Oral and biologic therapies were more common among patients with extensive skin involvement, while topical therapies were predominant in those with limited skin lesions.
- Quality of Life: Patients reported a significant impact on QOL, with high Dermatology Life Quality Index (DLQI) scores indicating moderate to severe impairment across different disease subgroups.
- Patient-Physician Disconnect: Misalignment between patient and physician perceptions regarding disease severity, treatment goals, and the impact of the disease on QOL was evident. This discordance underscores the need for improved communication and shared decision-making in treatment management, the authors noted.
- Unmet Treatment Needs: Patients expressed a strong desire for better treatment options, particularly focusing on itch reduction and joint pain relief as primary treatment goals.
Looking Ahead
These findings shed light on the evolving landscape of PsO in the US, highlighting persistent challenges and unmet needs in disease management. Moving forward, bridging the gap between patient expectations and physician perspectives will be crucial in enhancing outcomes and improving QOL for individuals living with PsO.
